Endometriosis is a common chronic benign gynecological disease affecting about 6–10% of all women. It is characterized by the presence of endometrium like tissue outside the uterine cavity, primarily on the ovaries and is an estrogen dependent condition generally limited to reproductive age. It progresses mostly in cases of moderate and severe disease but spontaneous regression can occur in 58% of milder cases. The purpose of medical and conservative surgical treatment of endometriosis is often to relieve symptoms in anticipation of a naturally occurring menopause. Occasionally, it is necessary to perform radical surgery with hysterectomy and bilateral oophorectomy to control symptoms and to avoid further surgery. Use of menopausal hormone treatment in women with prior history of endometriosis raises concerns in the mind of clinicians about disease recurrence with pain symptoms, need for surgery and possibly malignant transformation of residual endometriosis.